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Contact Information

MARK J ELLIS
1101 JEFFERSON BLVD
HAGERSTOWN, MD21742-5037
 Phone: 301-714-0200
 Fax: 301-739-8533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Care

2278G1100X
Indicates primary specialty

NPI Profile & details for MARK J ELLIS · (Male)

NPI Number 1336204171
Status Active
Credentials
Entity Individual
Enumeration date 12/22/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MD License # YM005079L
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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